Turkish Neurosurgery 1996 , Vol 6 , Num 3-4
POSTTRAUMATIC UNILATERAL DIFFUSE CEREBRAL SWELLING
Saim KAZAN, Recai TUNCER, Cem AIKBAS, zzet DEMREZ, Mete SAVEREN
Akdeniz University Faculty of Medicine, Department of Neurosurgery, Antalya, Turkey A series of 41 patients with posttraumatic unilateral diffuse cerebral swelling was studied in order to assess clinical, radiological and operative findings, to determine the incidence and outcome, and to seek features that might identify patients at high risk of unilateral cerebral swelling and a poor outcome. Diffuse and massive expansion of a single cerebral hemisphere, causing marked midline shift on computed tomography was used for diagnosis of these cases. Of 280 severely head injured patients, 14.64 % had a diagnosis of unilateral diffuse cerebral swelling. The most common associated intracranial pathology was subdural hematoma, found in 68.29 % of patients. The mortality rate was 53.65 %, and 34.14 % of patients had functional recovery. This study indicates that the patients at greatest risk of developing posttraumatic unilateral diffuse cerebral swelling are; those with acute subdural hematoma on the initial cranial computed tomography, low post-resuscitation Clasgow Coma Scale score, one or more abnormal pupils, or systemic injuries especially if major chest trauma or hypotension is involved. Keywords : Cerebral swelling, head injury, subdural hematoma
Corresponding author : Saim Kazan